Author + information
- Received May 1, 2019
- Revision received August 16, 2019
- Accepted August 20, 2019
- Published online December 16, 2019.
- Ali O. Malik, MDa,b,∗ (, )
- Mohamed Omer, MDa,b,
- Mathew C. Pflederer, MDa,b,
- Ahmed Almomani, MDa,b,
- Kensey L. Gosch, MSb,
- Philip G. Jones, MSb,
- Poghni A. Peri-Okonny, MD, MSca,b,
- Firas Al Badarin, MDa,b,
- Hunter A. Brandt, BSb,
- Suzanne V. Arnold, MDa,b,
- Michael L. Main, MDa,b,
- David J. Cohen, MD, MSca,b,
- John A. Spertus, MD, MPHa,b and
- Adnan K. Chhatriwalla, MDa,b
- aUniversity of Missouri–Kansas City, Kansas City, Missouri
- bSaint Luke’s Mid America Heart Institute, Kansas City, Missouri
- ↵∗Address for correspondence:
Dr. Ali O. Malik, University of Missouri–Kansas City/Saint Luke’s Mid America Heart Institute, 4401 Wornall Road, 9th Floor, Kansas City, Missouri 64111.
Objectives The aim of this study was to assess the association of baseline left ventricular diastolic dysfunction (LVDD) with health status outcomes of patients undergoing transcatheter aortic valve replacement (TAVR).
Background Although LVDD in patients with aortic stenosis is associated with higher mortality after TAVR, it is unknown if it is also associated with health status recovery.
Methods In a cohort of 304 patients with interpretable echocardiograms, undergoing TAVR, LVDD was categorized at baseline as absent (grade 0), mild (grade 1), moderate (grade 2), or severe (grade 3). Disease-specific health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OS) at baseline and at 1-month and 12-month follow-up. Association of baseline LVDD with health status at baseline and follow-up after TAVR was assessed using a linear trend test, and association with health status recovery (change in KCCQ-OS) was examined using a linear mixed model adjusting for baseline KCCQ-OS.
Results Twenty-four (7.9%), 54 (17.8%), 186 (61.2%), and 40 (13.2%) patients had LVDD grades of 0, 1, 2, and 3, respectively. Baseline KCCQ-OS was 61.3 ± 22.7, 51.0 ± 26.1, 44.7 ± 25.7, and 44.4 ± 21.9 (p = 0.004) in patients with LVDD grades of 0, 1,2 and 3. At 1 and 12 months after TAVR, LVDD was not associated with KCCQ-OS. Recovery in KCCQ-OS after TAVR was substantial and similar in patients across all severities of LVDD.
Conclusions Although LVDD is associated with health status prior to TAVR, patients across all severities of LVDD have similar recovery in health status after TAVR.
Drs. Malik, Peri-Okonny, and Al Badarin are supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under award T32HL110837. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Arnold is supported by a Career Development Grant Award (K23 HL116799) from the National Heart, Lung, and Blood Institute of the National Institutes of Health. Dr. Main has received research grants from Lantheus Medical Imaging, GE Healthcare, and Bracco. Dr. Cohen has received research grant support from Edwards Lifesciences, Medtronic, Boston Scientific, and Abbott; and has received consulting fees from Medtronic and Edwards Lifesciences. Dr. Spertus owns the copyright for the Kansas City Cardiomyopathy Questionnaire; has equity interest in Health Outcomes Sciences; has received consulting income from Novartis, Bayer, AstraZeneca, V-Wave, Corvia, and Janssen; has served on the advisory board for United Healthcare; and has served on the board of directors for Blue Cross Blue Shield of Kansas City. Dr. Chhatriwalla is on the Speakers Bureau for and has received travel reimbursement from Medtronic, Edwards Lifesciences, and Abbott Vascular; and has been a proctor for Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 1, 2019.
- Revision received August 16, 2019.
- Accepted August 20, 2019.
- 2019 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.